Sucking wound plug and chest aspirator

ABSTRACT

A unique inflatable bag catheter is provided having a pliable elongated bag disposed generally at the distal end thereof. A cylindrical end portion of the distal end may be formed with a plurality of apertures for the passage of fluids into the catheter from a space immediately adjacent the distal end. A terminal-most portion of the distal end of the catheter may be formed with a cushioning device to prevent damage to delicate internal portions of the body such as the lungs. A hand pump portion of the catheter may be threadedly and removably engaged with an inflatable balloon portion of the catheter. One-way valves may be provided in both the inflatable balloon portion of the catheter and the hand pump portion of the catheter to insure that fluids sucked in from the distal end of the catheter will travel only away from the distal end toward the proximal end of the catheter. One one-way valve may be disposed on either side of the hand pump which may comprise an elastomeric bulb. A conduit may be connected with the inflatable balloon for directing inflating fluids thereto. The free terminal end of the conduit may be fitted with threading corresponding with threading on the inflatable balloon portion of the catheter. Because of this arrangement, the hand pump may be attached initially to the conduit for inflating the balloon and then may be removed to be reconnected with the inflatable balloon portion of the catheter for evacuating fluids from within a body cavity. When the hand pump is threadedly engaged with the conduit for inflating the balloon, another one-way valve may be threadedly engaged within a free end portion of the elastomeric bulb portion of the catheter to convert the pump from a suction device to one for pressurizing of the inflatable balloon. In one alternative embodiment, a valved face mask may be provided to require a user to forceably exhale so as to increase the compression force on internal drainage fluids which force, in turn, permits the expulsion of undesirable internal fluids through the catheter by the pumping action of the chest wall.

United States Patent [1 1 Gray et al.

[ SUCKING WOUND PLUG AND CHEST ASPIRATOR [76] Inventors: R. FlanaganGray, RD. 1,

Washington Crossing, Pa.; John Caswell, 125 S. Chancellor St., Newtown,Pa. 18940; William G. Muller, 131 N. Delaware Ave., Yardley, Pa.

22 Filed: Jan. 8, 1971 21 Appl.No.: 104,960

A unique inflatable bag catheter is provided having a pliable elongatedbag disposed generally at the distal end thereof. A cylindrical endportion of the distal end may be formed with a plurality of aperturesfor the passage of fluids into the catheter from a space imme- Dec. 11,1973 diately adjacent the distal end. A terminal-most portion of thedistal end of the catheter may be formed with a cushioning device toprevent damage to delicate internal portions of the body such as thelungs. A hand pump portion of the catheter may be threadedly andremovably engaged with an inflatable balloon portion of the catheter.One-way valves may be provided in both the inflatable balloon portion ofthe catheter and the hand pump portion of the catheter to insure thatfluids sucked in from the distal end of the catheter will travel onlyaway from the distal end toward the proximal end of the catheter. Oneone-way valve may be disposed on either side of the hand pump which maycomprise an elastomeric bulb. A conduit may be connected with theinflatable balloon for directing inflating fluids thereto. The freeterminal end of the conduit may be fitted with threading correspondingwith threading on the inflatable balloon portion of the catheter.Because of this arrangement, the hand pump may be attached initially tothe conduit for inflating the balloon and then may be removed to bereconnected with the inflatable balloon portion of the catheter forevacuating fluids from within a body cavity. When the hand pump isthreadedly engaged with the conduit for inflating the balloon, anotherone-way valve may be threadedly engaged within a free end portion of theelastomeric bulb portion of the catheter to convert the pump from asuction device to one for pressurizing of the inflatable balloon.

In one alternative embodiment, a valved face mask may be provided torequire a user to forceably exhale so as to increase the compressionforce on internal drainage fluids which force, in turn, permits theexpulsion of undesirable internal fluids through the catheter by thepumping action of the chest wall.

13 Claims, 4 Drawing Figures PATENIEUUEC H I975 wVENTORS:

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ATTORNEYS SUCKING WOUND PLUG AND CHEST ASPIRATOR BACKGROUND OF THEINVENTION The invention relates to means for simultaneously sealing offatmospheric leaks into the chest and blood escaping from chest, suckingwounds of various irregular shapes, and for draining off fluids leakinginto the intrathoracic spaces defined by the lungs and chest wall. Moreparticularly, the invention relates to an inflatable bag catheter whichmay be installed within a body perforation by one unskilled in medicalpractices, and which then may be manually or automatically operatedwithout fear of overpressurizing the internal spaces adjacent thesucking wound.

In view of the high casualty rate of severly wounded men in lndo-China,and in view of the possibility of future conflicts among nations whichmay result in vast numbers of wounded men who might be saved ifimmediately and properly treated, it is imperative that continuingefforts be made to improve the medical tools available for preservingthe lives of such victims.

In war and at accident scenes, the medical expertise necessary to treata large sucking wound is, too often, not available. Such wounds, as alarge irregular perforation of the chest wall, can mean death to thevictim if not sealed and drained within a very short period of time. Ifthe wound is not sealed, the victim may, of course, die due to a loss ofblood. If the natural vacuum of the intrathoracic space, surrounding thelungs, is not promptly restroed, the victims breathing may be severelycurtailed.

Threfore, surgical apparatus must be advanced for providing a simple andinexpensive means for smultaneously sealing and draining such a wound asa perforation of the chest wall. Such apparatus must be operable by onehaving no medical training and must, itself, not present any hazards tothe life of the victim.

The cannula has been previously known in the surgical arts, and has beenutilized for withdrawing fluids from internal body spaces. For example,the catheter has long been used for draining fluids contained withininternal organs. More specifically, inflatable bag catheters have beenused commonly by physicians for many years to drain the internal organsof patients. Such catheters are comprised of thin walled, flexible,hollow drainage tubes provided with one or more lateral openings in thedistal end thereof to permit the passage of fluid contained within aninternal organ, into which the catheter has been inserted, to be drawninto the hollow tube and expelled at the proximal end of the tube. Thecatheter is provided, adjacent the distal end thereof, with a bulbousshape which may be, inflated to retain a catheter in operationalposition once the catheter has been inserted into the internal organ tobe drained. The inflatable bag is inflated through an inflation tubewhich connects with the inflatable bag and may extend to the proximalend of the catheter.

In using such an inflatable bag catheter, the distal end of the catheterfirst is inserted into the organ to be drained. Then, the inflatableretention bag is inflated by introducing a required amount of inflatingfluid, such as air or water. The inflating fluid is usually introducedthrough the use of a hypodermic syringe inserted through a plug in theinflation arm when a plug is used therein. When a valve is employed inthe inflation tube, the bag may be inflated by means of a syringeprovided with a tip capable of opening the valve. In view of the ratherdelicate operation involved, heretofore such an operation had to beperformed by those skilled in the surgical arts. Also, when such deviceswere applied to perforated flesh wounds as opposed to natural cavitiesof the body, additional problems were encountered.

One attempt at providing an effective means for sealing a woundcomprising a flesh perforation is evidenced by U. S. Pat. No. 3,253,594,issued to Matthews, et al, in 1966. Matthews, et al, disclose a cannulaor catheter having an inflatable bag disposed at a distal end thereof.Although the Matthews, et al, patent shows that a catheter with aninflatable bag attached thereto may be used to seal a perforation inbody flesh, the apparatus is rather crude and requires the use ofwashers and nuts for the installation thereof which may require or causean enlargement of the wound opening. Also, if the perforation were inthe chest cavity area, the Matthews, et al, apparatus makes no provisionfor removing gas and liquids draining into the intrathoracic space whichmaintains the vacuum which normally surrounds the lungs. This normalvacuum is of critical importance in that it permits natural unforcedinhalation upon chest expansion.

It would, therefore, be advantageous if a combined apparatus wereprovided which performed the dual functions of effectively sealing awound comprising a flesh perforation adjacent the chest cavity and whichautomatically withdrew fluids draining into the intrathoracic space inresponse to the natural movement of the chest during respiration.

OBJECTS AND SUMMARY OF THE INVENTION It is therefore an object of thepresent invention to provide a combined sucking wound plug and chestaspirator which solves many of the problems confronting the medicalprofession today.

It is another object of the present invention to provide a sucking woundplug and chest aspirator which may be installed by one who is notskilled in the surgical arts.

It is still another object of the present invention to provide a chestaspirator which may operate automatically in response to normal chestmovement during respiration.

It is yet another object of the present invention to provide a suckingwound plug and ichest aspirator which includes a hand pump which issimple, inexpensive, and may be automatically bypassed if the pumpingaction provided thereby is inadequate.

It is a further object of the present invention to provide a suckingwound plug and chest aspirator having a hand pump which may be used toboth inflate an inflatable bag portion of the catheter and to withdrawfluids draining into an internal space adjacent a perforated fleshwound.

It is still another object of the present invention to provide a simplemeans for sealing flesh perforations despite the permutations ofirregular shapes and sizes of such perforations. i

It is'yet another object of the present invention to provide a suckingwound plug and chest aspirator which may be inserted through a fleshperforation of a human body without fear of damaging the internal organsthereof.

It is still yet another object of the present invention to provide asucking wound plug and a chest aspirator having a hand pump which cannotbe operated in a manner that will place a damaging suction on aninternal space adjacent a perforated wound.

It is still yet a further object of the present invention to provide asucking wound plug and chest aspirator which is more effective,inexpensive, and versatile than the plugs or aspirators heretoforeknown.

It is another object of the present invention to provide a valved facemask means which cooperates with the aspirator to cause fluids to beexpelled from the intrathoracic space with relatively high force.

At least some of the above listed objects are carried out by theprovision of a unique catheter having an inflatable bag at a distal endthereof and a hand pump disposed adjacent a proximal end thereof. Oneway valve means is provided for directing fluid passage only from thedistal to proximal ends of the catheter. The catheter may comprise twoportions. The first portion of the catheter includes the proximal endand the hand pump means which may be operatively engaged with the secondportion including the distal end of the catheter for draining internalfluids, or with an inflation tube for inflating the inflatable bag.

In one independent feature of the invention, cushion means is providedat the terminal-most portion of the distal end of the catheter toprevent damage to internal organs and additional one-way valve means isprovided for use with the hand pump means to convert the pump from asuction to a pressurizing apparatus.

In another independent feature of the invention, a face mask provides aresistance to exhalation which assistance, in turn, increases the forcewith which internal fluids are expelled.

BRIEF DESCRIPTION OF THE DRAWINGS While the invention is particularlypointed out and distinctly claimed in the concluding portion of thespecification, a preferred embodiment is disclosed in the followingdetailed description, which may be best understood when read inconnection with the accompanying drawings in which:

FIG. 1 is a partial axial sectional view of a distal end portion of anapparatus according to the present invention, properly installed withina chest wall perforation;

FIG. 2 is an axial sectional view of a first portion of the catheter,which may be connected with either a body fluid draining tube or aninflation tube of the second portion of the catheter;

FIG. 3 is an axial sectional view of a one-way valve which may be usedin combination with the first portion shown in FIG. 2 to convert a pumpof the first portion from a suction apparatus to a pressurizingapparatus; and

FIG. 4 is a sectional view ofa valved face mask which may be used incombination with the apparatus of FIG. 1.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT Referring now to thedrawings, FIGS. 1 and 2 show an inflatable balloon catheter assemblyaccording to the present invention. The assembly includes a firstportion 16 and a second portion which is installed within a perforation12 defined within a patients chest wall 14. The portion 10 of theoverall catheter will be referred to herein as the distal end portion ofthe catheter.

FIG. 2 shows the first portion 16 of the inflatable balloon catheter,which portion shall be referred to herein as the proximal portion. Itcan readily be seen, that the proximal portion 16 may be threadedlyengaged with the distal portion 10 to form an operable apparatus by theengagement of the male threads 18 of portion 10 within the femalethreads 20 of the portion 16.

It will be noted that the distal portion 10 of the overall apparatus isprovided with an inflatable bag 22, which may be of a very pliableelastomeric substance. The bag 22 may be formed with end walls 24 and26, having areas which may be expected to be generally larger than thecross-sectional areas of a chest wall perforation to be sealed. In thismanner, the generally cylindrical portion of the balloon 28 extendingbetween the end walls 24 and 26 may fit snugly within the variousirregular surfaces, e.g. surface 30, of the marginal edges of the chestwall 14, defining the perforation 12.

The terminal distal end of the catheter may be of a generallycylindrical configuration, having apertures 32 formed therein for thepassage of body fluids from an intrathoracic space 34 surrounding thedistal end into the internal passageway 36 of the overall catheterassembly. A very soft cushioning means 38 may be presented on theterminal-most edge of the distal end of the catheter to prevent damageto any delicate internal organs such as the lung 40.

An inflating tube 42 may be connected with the inflatable bag 22 fordirecting inflating fluid thereto. The tube 42 may be provided with avalve 44 and a threaded fitting 46 at a terminal free end thereof.

The second portion 16 of the catheter assembly may be formed withinternal female threadiiig 48 which corresponds with the male threadingof the fitting 46 of the inflation tube 42. Through this correspondenceof the various male and female threadings of the various members of theoverall assembly, the hand pump, which, in the preferred embodiment,comprises an elastomeric bulb 49, may be operatively attached to thedrainage tube portion of the catheter 10 by engaging threads 18 withinthreads 20 or may bel attached to the bag inflating tube 42 by theengagement of female threads 48 of the catheter portion 16 with the malethreading 46 of the inflating tube 42.

A unique arrangement of one-way valves is provided throughout theoverall assembly. A orie-way valve 50 is provided in the portion 16 ofthe catheter intermediate the terminal ends thereof. The valve 50comprises two end plates 52 and 54, having axialiy aligned apertures 56and 58, respectively, formed therein. A valve disc 60 is urged againstthe end plate 56 to seal the aperture formed thereby by means of ahelical spring 62 which urges at its opposite end againsttthe second endplate 54.

In operation, after the portion 10 of the overall catheter has beenproperly inserted within a flesh perforation 12 and after the inflatablebag 22 has been inflated by directing pressurized fluid through gthetube 42, so that the inflatable bag tightly seals and adheres within allthe various jagged portions 30 of thd perforation 12, the normal actionof the lung 40 in combination with the compression forces of the chestwall during exhalation will assert pressure against any fluids withinthe intrathoracic space 34. The overpressure applied to the fluidswithin the space 34 will then force the fluid in through the apertures32 to the passageway 36 of the catheter and will simultanously force thevalve disc 60 to lift off the seat formed by the valve end plate 52.When the chest wall is restored to an expanded position, there is nolonger an overpressure with respect to the spring 62 of the one-wayvalve, so that the valve disc 60 is urged against its seat 52 formed byend plate 56 and fluid cannot return through the catheter into the space34 through the apertures 32. It can be see that, through this operation,the normal breathing of a patient will cause the systematic and cyclicpumping of any fluid which has seeped into the intrathoracic space.

If the normal breathing action of the patient should be insufficient tooperate the one-way valve 50, the portion 16 of the assembly may beconnected to provide proper suction for draining fluids from theintrathoracic space. The installation of the portion 16 will notinterfere with normal automatic chest aspiration due to respiration and,therefore, a single operator may take rest periods between periods ofmanual pumping.

The portion 16 of the overall apparatus may comprise a relatively rigidtube 64, having the elastomeric bulb 49 formed integrally therewith. Asecond one-way valve 66 may be provided within the tube 64 and may be ofthe same configuration and structure as the last described one-way valve50. The one-way valves 50 and 64 must be operable to pass fluid in thesame direction when the female and male threadings 20 and 18respectively, of the first portion and the second portion of theapparatus are connected.

When the portion 16 is connected with the inflating tube 42 by means offemale threads 48 engaging on the male threads 46 of the tube 42, athird one-way valve 68 may be installed within the portion 16 to convertthe pump to a pressurizing device. FIG. 3 shows a tubular housing forthe one-way valve 68, which housing is provided with male threading 70at one end thereof for engagement within female threading 20 of theportion 16 of the overall assembly. The one-way valve 68 may beidentical in configuration with the two other valves 50 and 64.

When it is desired to inflate the bag 22 by means of the elastomericbulb 49, the female threads 48 are engaged within the male threads 46 toconnect the hand pump with the tube 42 and the one-way valve 68 isattached to the other end of the portion 16, by engaging the malethreads 70 within the female threads 20. With the hand pump attached inthis manner, squeezing the hand pump aspirates air through the one-wayvalve 68 and forces air through the one-way valve 66 into the inflatablebag 22. When the bag is properly inflated, the valve 44 on the conduit42 is closed to trap the pressurized fluid in the bag 22. Any suitablefluid may be used in inflating the bag 22.

FIG. 4 shows a face mask 100, which may be used in combination with thecatheter portion of the present invention. The mask 100 may comprise anelastomeric substance such as natural rubber and may be held in anoperational posture by conventional head straps 102 which may beconnected with a portion of the mask by hooks 104 or the like. Valve 44may offer pressure relief.

The mask 100 may be provided with a sealing ring 106 disposed about themarginal edge thereof. A flapper valve 108 and a spring loaded valve 110may be mounted generally centrally of'the mask 100. The flapper valve108 comprises a cylindrical body 112 and a hinged valve member 114,which swings freely inwardly to permit ease of inhalaton but closes whenmoved outwardly to prevent exhalation therethrough. The valve 110 isarranged to prevent inhalation therethrough and to permit only forcedexhalation against the bias of the spring 116.

The overall effect of the valves 108 and 110 is to cause the user of themask to inhale freely but to exhale forcibly. The forced exhalation isoperable to increase the chest wall pressures on fluids in theintrathoracic space to increase the force with which they are expelledthrough the catheter apparatus. Thus, it can be seen that the face mask100 cooperates with the catheter apparatus in a synergistic manner toproduce the new and improved functional result of expelling undesirableinternal fluids utilizing the action of a patients respiratory movementmore efficiently than heretofore possible.

SOME ADVANTAGES OF THE PRESENT INVENTION It can thus be seen that acombined sucking wound plug and chest aspirator has been herein providedwhich may be installed by one not skilled in the surgical arts. Theconfiguration of the inflatable bag 22 of the catheter apparatus is suchas to provide a tight seal with the jagged marginal edges of a chestwall perforation. The distal end cushion 38 insures that the overallcatheter may be inserted within a perforation without damaging internalorgans such as the lung 40. Th first portion 10 of the overall assemblymay function without any additional auxiliary equipment as an automaticpump whereby overpressure caused by the expansion of the lung on fluidswithin the intrathoracic space 34, force the cyclic opening and closingof the one-way valve 50 so as to expel fluids draining into the space34. The face mask may be utilized to increase the resistance toexhalation which, in turn, increases the pressures in the intrathoracicspaces to aid the natural forces of respiration in the expulsion offluids. If the natural respiratory action of the lung is insufficient toproperly expel the unwanted fluids, the hand pump 49 may be attached bythe threaded engagement of the male threads 18 within the female threads20. Since the pumping action of the hand pump 49 is effected only whenthe elastomeric bulb is released to move from a contracted to anexpanded condition due to the natural resiliency of the elastomericmaterial comprising the bulb, it is impossible for an excited oroverzealous operator to exert too much pumping force on the internalspace 34 of the patient.

Since the hand pump 49 may be utilized to either drain fluids from theintrathoracic space 34 or to pressurize the inflatable balloon 22, theoverall apparatus is provided with more versatility than heretoforeknown. The interaction of the various parts of the overall assemblyoperate in a synergistic manner to simultaneously provide the dualfunctions of sealing perforated body wall and of draining harmful fluidsdeveloping within the intrathoracic space so as to restore properbreathing. l

SCOPE OF THE INVENTI ON While what has been shown herein is thepreferred embodiment of the present invention, it is, of course,understood that various modifications and changes may be made thereinwithout departing from the inven tion. It is, therefore, intended tocover in the following claims all such modifications and changes as mayfall within the true spirit and scope of the present invention.

What I claim is:

1. Apparatus comprising:

catheter means having a distal end and a proximal end; inflatable bagmeans disposed at said distal end of said catheter means;

inflating tube means for directing inflating fluid to said inflatablebag means;

cushioning means presented on a terminal-most portion of said distal endof said catheter means; suction forming means for drawing fluid inthrough said distal end of said catheter means; and

first one-way valve means disposed in said catheter means and operableto pass fluid from said distal end of said catheter toward said proximalend of said catheter in response to overpressure being transmittedthereagainst by fluid disposed within and adjacent said distal end.

2. An apparatus according to claim 1, wherein said inflatable bag meanshas end walls having areas generally larger than the cross-sectionalareas of a chest wall perforation to be sealed and said inflatable bagmeans has a generally cylindrical portion extending between said endwalls so that said generally cylindrical portion engages snugly withinvarious irregular surfaces of said chest wall perforation.

3. An apparatus according to claim 1, wherein said suction forming meanscomprises hand pump means; and

said hand pump means forms a portion of a continuous closed fluidpassageway extending from said distal end to said proximal end of saidcatheter means.

4. An apparatus according to claim 3, wherein said hand pump meanscomprises an elastomeric bulb formed as a part of said catheter anddisposed intermediate the terminal ends thereof.

5. An apparatus according to claim 4, wherein said first one-way valvemeans comprises one valve disposed on each side of said elastomericbulb.

6. An apparatus according to claim 5, wherein a first portion of saidcatheter including said proximal end presents said elastomeric bulb andis detachably connected with a remaining second portion of said catheterwhich second portion includes said distal end.

7. An apparatus according to claim 6, wherein a first end of said firstportion of said catheter is formed with a first female threading and afirst end of said second catheter portion is formed with a first malethreading corresponding with said first female threading;

a second end of said first portion of said catheter being formed withsecond female threading;

a first end of said inflating tube means being formed with malethreading corresponding with said second female threading of said secondportion of said catheter;

a second one-way valve means being removably en gageable within saidfirst female threading of said first portion of said catheter; and

whereby said first portion of said catheter may be initially threadedlyengaged with said inflating tube means for directing fluid to saidinflatable bag means with said second one-way valvemeans being engagedwithin said first female threading of said first portion of saidcatheter and vmay then be removed from said inflating tube means andthreadedly engaged within said second portion of said catheter forsucking fluids in through said distal end of said catheter and expellingsaid fluids through said proximal end after said second oneway valve hasbeen removed.

8. A combined plug and chest aspirator for sealing wounds penetratingthe chest wall cavity, comprising:

an inflatable bag catheter;

tube means for conducting fluid to said inflatable bag;

cushion means disposed at the terminal-most portion of a distal end ofsaid catheter;

hand pump means provided on said catheter;

a first one-way valve disposed in said catheter between said hand pumpmeans and a proximal end of said catheter;

a second one-way valve disposed in said catheter between said hand pumpmeans and said distal end of said catheter; and

said first and said second valves operable to pass fluid from saiddistal end of said catheter toward said proximal end thereof.

9. A combined plug and chest aspirator according to claim 8, whereinsaid catheter comprises a first portion and a second portion;

said first portion having said hand pump and said first one-way valve; 1

said second portion having said inflatable bag and said second one-wayvalve;

a first end of said first portion being provided with female threading;

a first end of said second portion being formed with male threadingcorresponding with said last mentioned female threading; a

a free end of said tube means for conducting fluid to said inflatablebag having male threading; and

said first portion of said catheter being formed with female threadingat a second end thereof corresponding with said male threading formed onsaid tube means for conducting fluid to said inflatable bag.

10. An apparatus according to claim 8, wherein said inflatable bagcomprises two generally radially extending end walls and a generallycylindrical surface extending therebetween; and whereby the outerperiphery of said end walls extend beyond the peripheral extent of abody perforation and said cylindrical surface is operable to engageflush against an irregular surface of the marginal edges defining theperforation in response to the inflation of said inflatable bag.

11. An apparatus according to claim 9, wherein said hand pump meanscomprises an elastomeric bulb.

12. An apparatus according to claim 11, wherein each said one-way valvecomprises two radially extending end walls having axially alignedapertures; and

a valve disc is spring biased against one of said apertures.

13. An apparatus according to claim 11, wherein a second one-way valvemeans is releasably engaged within said first portion of said catheter;and

whereby said elastomeric bulb may be converted from a suction forming toa pressure forming means.

1. Apparatus comprising: catheter means having a distal end and aproximal end; inflatable bag means disposed at said distal end of saidcatheter means; inflating tube means for directing inflating fluid tosaid inflatable bag means; cushioning means presented on a terminal-mostportion of said distal end of said catheter means; suction forming meansfor drawing fluid in through said distal end of said catheter means; andfirst one-way valve means disposed in said catheter means and operableto pass fluid from said distal end of said catheter toward said proximalend of said catheter in response to overpressure being transmittedthereagainst by fluid disposed within and adjacent said distal end. 2.An apparatus according to claim 1, wherein said inflatable bag means hasend walls having areas generally larger than the cross-secTional areasof a chest wall perforation to be sealed and said inflatable bag meanshas a generally cylindrical portion extending between said end walls sothat said generally cylindrical portion engages snugly within variousirregular surfaces of said chest wall perforation.
 3. An apparatusaccording to claim 1, wherein said suction forming means comprises handpump means; and said hand pump means forms a portion of a continuousclosed fluid passageway extending from said distal end to said proximalend of said catheter means.
 4. An apparatus according to claim 3,wherein said hand pump means comprises an elastomeric bulb formed as apart of said catheter and disposed intermediate the terminal endsthereof.
 5. An apparatus according to claim 4, wherein said firstone-way valve means comprises one valve disposed on each side of saidelastomeric bulb.
 6. An apparatus according to claim 5, wherein a firstportion of said catheter including said proximal end presents saidelastomeric bulb and is detachably connected with a remaining secondportion of said catheter which second portion includes said distal end.7. An apparatus according to claim 6, wherein a first end of said firstportion of said catheter is formed with a first female threading and afirst end of said second catheter portion is formed with a first malethreading corresponding with said first female threading; a second endof said first portion of said catheter being formed with second femalethreading; a first end of said inflating tube means being formed withmale threading corresponding with said second female threading of saidsecond portion of said catheter; a second one-way valve means beingremovably engageable within said first female threading of said firstportion of said catheter; and whereby said first portion of saidcatheter may be initially threadedly engaged with said inflating tubemeans for directing fluid to said inflatable bag means with said secondone-way valve means being engaged within said first female threading ofsaid first portion of said catheter and may then be removed from saidinflating tube means and threadedly engaged within said second portionof said catheter for sucking fluids in through said distal end of saidcatheter and expelling said fluids through said proximal end after saidsecond one-way valve has been removed.
 8. A combined plug and chestaspirator for sealing wounds penetrating the chest wall cavity,comprising: an inflatable bag catheter; tube means for conducting fluidto said inflatable bag; cushion means disposed at the terminal-mostportion of a distal end of said catheter; hand pump means provided onsaid catheter; a first one-way valve disposed in said catheter betweensaid hand pump means and a proximal end of said catheter; a secondone-way valve disposed in said catheter between said hand pump means andsaid distal end of said catheter; and said first and said second valvesoperable to pass fluid from said distal end of said catheter toward saidproximal end thereof.
 9. A combined plug and chest aspirator accordingto claim 8, wherein said catheter comprises a first portion and a secondportion; said first portion having said hand pump and said first one-wayvalve; said second portion having said inflatable bag and said secondone-way valve; a first end of said first portion being provided withfemale threading; a first end of said second portion being formed withmale threading corresponding with said last mentioned female threading;a free end of said tube means for conducting fluid to said inflatablebag having male threading; and said first portion of said catheter beingformed with female threading at a second end thereof corresponding withsaid male threading formed on said tube means for conducting fluid tosaid inflatable bag.
 10. An apparatus according to claim 8, wherein saidinflatable bag comprises two generally radially extEnding end walls anda generally cylindrical surface extending therebetween; and whereby theouter periphery of said end walls extend beyond the peripheral extent ofa body perforation and said cylindrical surface is operable to engageflush against an irregular surface of the marginal edges defining theperforation in response to the inflation of said inflatable bag.
 11. Anapparatus according to claim 9, wherein said hand pump means comprisesan elastomeric bulb.
 12. An apparatus according to claim 11, whereineach said one-way valve comprises two radially extending end wallshaving axially aligned apertures; and a valve disc is spring biasedagainst one of said apertures.
 13. An apparatus according to claim 11,wherein a second one-way valve means is releasably engaged within saidfirst portion of said catheter; and whereby said elastomeric bulb may beconverted from a suction forming to a pressure forming means.